Dentist help

[adventuresinbabysitting]

I take propranolol beta blockers for anxiety daily.

I need to have a tooth extraction.

Everything I am reading tells me that local anaesthetic (all kinds) are dangerous for me. I asked my last dentist who laughed and said don't worry well I am worried and it's worrying me so much that I am putting off the treatment and am suffering.

Can any dental folk help ease my fears that there is a local that is compatible with this drug?

Everything I am reading tells me that local anaesthetic (all kinds) are dangerous for me.

By local anesthetics do you mean something injected into the gum, like Novocaine? What have you read that says that you can't have a LA with your beta blocker?

There is a caution for them with surgical, systemic anesthesia

www.ncbi.nlm.nih.gov/pubmed/942819

But not local. Something like Novocaine doesn't leave the area where it's injected.

www.dental-risk.com/Portals/20/articles/Local%20anesthesia.pdf

It's documented in lots of places that they do interact.

What the article you link to actually says is that the vasoconstrictor, an additive to the local anaesthetic to reduce bleeding/ increase duration of anaesthesia, should be considered & perhaps consider reducing the dose.
The most common is adrenaline which if injected into a blood vessel (rare - I've never done it) can raise heart rate for a few mins until it wears off.
You could ask for adrenaline free anaesthetic but personally I don't think they give as profound anesthesia & I prefer guaranteed good anaesthesia for an extraction.
I would use standard anaesthetic in a standard amount but use very careful injection tècnique to avoid intra vascular injection, but I'd do that for anyone anyway.

Thanks, that makes me feel better the way you have explained it.

So you would have no reservations working on someone who takes this medication? And if I ask for a local without adrenaline, what would that be called?

I'd have no concerns what so ever. What people use will vary, I keep citanest with octapressin as an adrenaline free alternative but rarely use it. I usually have a chat as per above & see what people want to use, most go for the standard anaesthetic after a bit of reassurance.

I have had local while on beta blockers (same ones) with no issue. Both dental and skin local anaesthetic

The vasoconstriction also helps minimize bleeding.